On the occasion of World AIDS Day, 1 December, the WHO Regional Office for the Eastern Mediterranean is putting the spotlight on the HIV treatment gap in the Region.
The Eastern Mediterranean Region is experiencing the fastest rate of increase of the HIV epidemic in the world. At the same time, it is providing the lowest coverage of HIV prevention, treatment and care services. Among the estimated 561 000 people living with HIV in the Region, more than 85% of those in need life-saving antiretroviral therapy do not receive it.
The main contributor to this treatment gap is the low uptake of HIV testing and counselling services. In particular, people at higher risk of HIV, that is, people who inject drugs, men who have sex with men and sex workers, are still not being reached by available testing and counselling services.
The global theme for the World AIDS Campaign this year is “Getting to Zero”, referring to the goal of zero new HIV infections, zero discrimination and zero AIDS-related deaths. To achieve this goal, the Region must close the treatment gap and scale up HIV testing and counselling and other preventive approaches. For this reason, the regional AIDS campaign 2012 is aimed at promoting HIV testing and counselling as a key service to increase access to HIV treatment and care.
Less than 15% of those who need HIV treatment in the Region are actually receiving it. The main bottleneck is that less than 5% of the population of the Region knows its HIV status. Lack of awareness, fear of stigma and discrimination and inadequate service delivery prevent people from taking an HIV test.
In a message on the occasion of World AIDS Day, Dr Ala Alwan, WHO Regional Director for the Eastern Mediterranean, emphasized the importance of testing and counselling. “It starts with an HIV test. HIV testing and counselling services are an imperative gateway to HIV prevention, treatment and care. By knowing their HIV status, people living with HIV can access treatment and care services. With counselling and necessary behaviour change interventions, people living with HIV can also prevent further transmission of the virus to others; and people who are HIV negative can assert their personal choices, which can help them maintain a life without HIV.”
The global number of people living with HIV amounts to 34.2 million people. The World AIDS Campaign focus on “Zero AIDS related deaths” signifies a push towards greater access to treatment for all; a call for governments to act now and to hit targets for domestic spending on health and HIV.
In over 30 years since the appearance of HIV, the understanding of the virus and its transmission dynamics has grown. Similarly, the evidence with regard to effective interventions has accumulated, increasing the ability to care for and treat those who are living with HIV, and to control the spread of the virus.
HIV testing and counselling services should also be made available where further transmission of HIV can be controlled, such as in antenatal care services for the prevention of mother-to-child transmission of HIV. Also, HIV testing should be adapted in accordance with social and cultural norms, HIV testing should beroutinely offered to tuberculosis patients and patients with sexually transmitted infections.
“I call upon countries, civil society and technical partners to make available and improve access to HIV testing and counselling. I call upon individuals to seek HIV testing and counselling. It starts with an HIV test. When you know better, you live better.” said Dr Alwan.
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